Emergency Medicine Half and Half MAT Waiver Training-Module 1: Methadone and Naltrexone

Module 1: Methadone and Naltrexone

Pdf Summary

Methadone and naltrexone are two medications used in the treatment of opioid use disorder (OUD). Methadone is a synthetic opioid that acts as a full agonist at the mu receptor. It has a long half-life and is metabolized in the liver. Methadone is commonly administered in specialized clinics and its dose is carefully adjusted for each patient. It is effective in treating OUD but requires daily travel to the clinic which may be inconvenient for some patients. Methadone should be used with caution in the treatment of pain as it has a high risk of dependency and respiratory depression.<br /><br />Naltrexone, on the other hand, is a full antagonist at the mu receptor. It blocks the effects of opioids and is used in both detoxification and maintenance treatment for OUD. Naltrexone can be administered orally or via a monthly extended-release injection. It is also used to treat alcohol use disorder. However, naltrexone should not be initiated in the emergency department and patients should be opioid-free for at least 7-10 days before starting treatment.<br /><br />Both methadone and naltrexone have their advantages and challenges. Methadone provides structure and on-site monitoring but requires daily travel to the clinic. Naltrexone, on the other hand, is more convenient but has lower adherence rates. The effectiveness of naltrexone in reducing cravings and preventing relapse increases with longer durations of treatment.<br /><br />It is important to note that the prescribing and dosing of methadone is not reported to state prescription drug monitoring programs (PDMPs). Therefore, verifying a patient's dose may require direct contact with their clinic. Methadone treatment should not be initiated or provided in the emergency department without proper verification from the clinic.<br /><br />In summary, both methadone and naltrexone are effective medications for treating OUD, but they have different pharmacological features, dosing requirements, and administration methods. It is important for healthcare providers to have a thorough understanding of these medications in order to make informed treatment decisions for patients with OUD.

Keywords

Methadone

Naltrexone

Opioid Use Disorder

Treatment

Synthetic Opioid

Full Agonist

Mu Receptor

Liver Metabolism

Specialized Clinics

Dose Adjustment